§ 48.17 Health and Medical Care.
RCNY § 48.17
(a)A camp health program must be maintained under the supervision of a camp health director and must include: the keeping of comprehensive health records, including records of physical examinations and immunizations of each child and each staff or volunteer; information indicating appropriate and adequate food and nutrition for campers and staff; emergency plan; first aid procedures; plan for reported accidents; search and rescue for lost, missing and runaway persons; daily observation of the children; daily check of food service and food service facilities and adequate cleanliness and maintenance of all facilities.
(b)Prior to or at admission, the camp director must obtain and maintain from every child in camp required medical records that includes a thorough medical examination by a licensed physician dated within 1 year prior to admission to camp. Such record must include a signed statement containing a summary of the results of the examination, the past medical history and, if a disease or abnormal condition is found, recommendations for exclusion or treatment of the child, or any modifications of diet or activities. In addition, each camper medical record must include the children's immunization record which must include proof of immunization against diphtheria, tetanus, pertussis, poliomyelitis, measles, mumps, rubella, varicella, hepatitis B, pneumococcal disease and haemophilus influenzae type b (Hib). A child may be exempted from this immunization requirement for CDC Advisory Committee on Immunization Practices (ACIP)-recognized medical contraindications, or other nationally-recognized evidence-based guidelines, upon submission of appropriate documentation from a physician licensed in the State of New York. Documentation of immunizations and exemptions must be kept on site and made available to the Department immediately upon request. If such records are maintained electronically, Department staff must be allowed to access such records while on-site. Proof of required child immunizations must be made available for review by the Department immediately upon request and must be established by: (1) A certificate of immunization prepared and signed by a physician licensed in the State of New York documenting that the child has been fully immunized against the diseases listed in this subdivision. The certificate of immunization must specify the products administered and the dates of administration. It may also show verified history of varicella disease and/or laboratory evidence of immunity to measles, mumps, rubella, varicella and Hepatitis B. A record issued by NYSIIS, the CIR, an official immunization registry from another state, an electronic health record, and/or an official record from a foreign nation may be accepted as a certificate of immunization without a health practitioner's signature.
(2)Documentation that the child is in process of receiving an immunization for which the child is not fully immunized, as follows: (i) a child has received at least the first dose in each immunization series required by this subdivision (except in the case of live vaccines in which a child should wait 28 days after one live vaccine administration before receiving another live vaccine, if the vaccines were not given on the same day) and has age-appropriate appointments to complete the immunization series according to the ACIP Recommended Immunization Schedules for Persons Aged 0 through 18 Years; (ii) a child is obtaining serologic tests within 30 days of notification of the parent/guardian that such testing is requested; or (iii) a child's serologic test(s) are negative, and therefore the child in question has appointments to be immunized within 30 days of notification of the parent/guardian to complete, or begin completion, of the immunization series based on the ACIP Recommended Immunization Schedules for Persons Aged 0 through 18 Years.
(3)Children who are not fully immunized can only continue to attend camp if they are in the process of completing the immunization series based on the ACIP Recommended Immunization Schedules for Persons Aged 0 through 18 Years. If a child does not receive subsequent doses of vaccine in an immunization series according to the age appropriate ACIP catch-up schedule, including at appropriate intervals, the child is no longer in process and must be excluded from camp within 14 days.
(4)No owner, operator, or director of a camp shall permit any child to attend such camp without appropriate documentation of the immunizations required by this subdivision, except as provided for in this subdivision.
(c)All staff, including volunteers and kitchen and maintenance staff, must have had a medical examination dated within 2 years of working with the camp, indicating that they are physically able to perform their camp duties. The Department may require testing for tuberculosis at any time of any staff or volunteer when such testing is deemed necessary for epidemiological investigation.
(d)Each camp must provide in their written safety plan, the location and contact information to the nearest hospital, clinic, urgent care or doctor's office, as close as possible to the camp where children or staff can be taken in case of serious injury or illness.
(e)Necessary emergency medical care. When a child or staff is injured or becomes ill under such circumstances that emergency care is needed, the permittee must obtain such emergency medical care in accordance with the requirements of this section and immediately notify the person's parent, guardian or emergency contact.
(1)Each permittee must: (i) at the time of the child's admission into the program, obtain written consent from a parent or guardian authorizing the permittee or other caregivers to obtain emergency health care for the child; and (ii) secure emergency care when needed, and notify a parent or guardian immediately, and (iii) arrange for any needed transportation of any child in need of emergency health care and ensure that the required staff / child ratios are maintained for the children remaining in the program.
(f)All camper and staff injuries, illnesses, and diseases and conditions reportable to the Department in accordance with 24 RCNY Health Code Article 11, must be reported to the camp health director and recorded in the medical log, including the date and time of the illness or injury, nature of complaint, diagnosis, treatment, disposition of case, area in camp where the accident causing the injury occurred, activity in which accident victim was engaged and tool or item of program equipment or other object causing injury.
(g)Within 24 hours, any of the following must be reported by the camp to the Department: (1) all camper and staff injuries or illnesses which result in death or which require resuscitation or admission to a hospital; (2) all instances where epinephrine was administered to a staff member or camper; (3) camper injuries to the eye, head, neck or spine which require referral to a hospital or other facility for medical treatment; (4) camper injuries where the victim sustains 2nd or 3rd degree burns to 5 percent or more of the body; (5) camper injuries which involve bone fractures or dislocations; (6) camper lacerations requiring sutures or glue; (7) allegations of camper abuse or neglect (as defined in 24 RCNY Health Code § 48.25(a)(3)(i)); (8) all camper and staff illnesses suspected of or confirmed as being water-, food- or air-borne, or spread by contact; (9) any persons exposed to rabies; and (10) any lost campers.
(h)The camp director must isolate and exclude any child or staff member who is suspected or confirmed with, or has been exposed to, a communicable disease requiring isolation or exclusion under 24 RCNY Health Code Article 11. Any child or staff member who has been excluded must not be permitted to return to the camp without a written statement from a health care provider indicating that the child or staff member is free from such disease in communicable form and that the period of isolation or exclusion required by 24 RCNY Health Code Article 11 has ended.
(i)At all camps, there must be a current and fully-equipped first aid cabinet with appropriate contents relative to the size and activities of the camp and ability to contact 911. All camps which travel from their home base must carry with them a first aid kit that must be stocked to treat a broad range of injuries and situations commensurate with the number of children present.
(j)An infirmary having hot and cold running water, examining room, isolation area, convalescent space, bathroom with flush toilets and showers must be provided at all camps with 100 or more persons in residence, including staff.
(k)In all non-overnight camps, a quiet place must be set aside away from the group where a child with a minor illness or injury can relax with an adult counselor in attendance. (Amended City Record 12/26/2019, eff. 1/25/2020)
